The New York Times has some helpful interactive infographics on this year’s congressional elections. Notice how slim the margin is between a Democrat and a Republican controlled House. Also, despite how much their executives must despise the Internet for what it has done to the newspaper industry, the Times consistently makes outstanding use of this new medium.

Asymco calls it like it is:

If the 1 million/day benchmark holds, and all indications are that it will, then the total smartphone/iPad/touch market will be greater than the total PC market next year.

The healthcare IT industry seems oblivious to this seismic shift. Eclypsis, Epic, and Cerner are the only EMR vendors whose products really meet meaningful use criteria. How many of them have iOS or Android apps? Two: Eclypsis and Epic. Of these apps, how many offer functionality for nurses and ancillary staff? Zero.

Technology company executives take heed: the future is touch. Now is the time to pour resources into this new market. If you don’t, your companies will soon be muscled out of relevance by upstarts who get it.

Tennessee Republicans have been protesting the expansion of a local Islaamic center down in Murfreesboro on the grounds that it is a terrorist training camp in disguise. They actually believe this, as a Daily Show interview with local opposition organizer Laurie Cardoza-Moore reveals. Since appearing on the show, Cardoza-Moore claims that she’s been receiving death threats on her cellphone. I have my doubts. Judging by her Daily Show interview, she looks about as divorced from reality as one can get without being a candidate for an involuntary admission.

Apple hosted it’s yearly iPod event today from California, debuting lots of new products. Interested parties can visit Apple’s homepage to see it all firsthand. Here are the items that excited me the most.

iPod Touch: Thinner, Video Chat, HD Video/Photo Camera.
This is the christmas present this year. There are plenty of people you know who don’t want an iPhone but would enjoy having an ultra-portable, ultra-slim video camera + internet device + video chat device in their pocket or purse. FaceTime video chats work internationally, and without any phone carrier charges. The audio quality is better than any other type of international call as well (mobile call, Skype, AIM, Google Voice, etc.). Coupled with the same Retina Display and dual camera setup as the iPhone 4, the new iPod touch is easily worth the $229 entry price.

iOS 4.2 Wireless Printing, Wireless Audio/Video Streaming to your TV & Stereo.
Steve Jobs previewed some killer features of iOS 4.2 today during his iPad round-up. The notable additions include the ability to print documents directly from an iPad to a wifi-networked printer, and the ability to stream audio and video from the iPad wirelessly to your home stereo or television (Airport Express base station or soon-to-be-released, next-generation Apple TV required). Although the website doesn’t yet explicitly state as much, it isn’t a stretch to assume that these features will be extended to the iPhone and iPod Touch as well.

Orange, a UK mobile phone carrier, has debuted a new high-definition phone service called HD Voice. Although the service requires that you purchase a new mobile phone, the calls themselves don’t use any hardware not already present in most phones. Orange has made HD Voice an open standard in the UK. I hope that something similar follows in the states.

I’ve been waiting for something like this to happen for years. If you’ve ever owned a mobile phone with a memo recording feature, then you know that the clarity of the phone calls we make has nothing to do with the hardware in our devices and everything to do with the amount of bandwidth that our carriers are willing to expend on voice calls. We’ve had mobile phones for decades without any appreciable improvement in sound quality.

iMedicalApps reviews some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too:

All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.

iPad enthusiast medical bloggers, and there are many, have been making optimistic predictions like these since the iPad was first revealed. I wish that I could share in their optimism, but I think that they too easily confuse a vision of what is possible with what is probable.

In the abstract, the power of touchscreen iOS devices could be the best thing to happen to healthcare IT ever. I see it benefitting nurses and pharmacists as much, if not more than, physicians. But there are a lot of things that would need to happen to make this vision a reality. Unfortunately, the history of healthcare IT is a story of under-planned implementations of misguided ideas, followed by pessimistic refusals to implement demonstrably better alternatives. Here are the obstacles I see:

1) For the iPad to become ubiquitous in healthcare, IT departments would need to overcome decades of unease with Apple products. Many IT guys I know flat-out refuse to touch them, despite the fact that they are much easier to manage than Windows machines.

2) EMR vendors would need to develop genuinely useful, native apps, and not just for physicians to review records. For the iPad to make an impact, EMR apps would need to offer a complete set of features, including support for nursing, pharmacy, and ancillary personnel. These apps cannot be one-to-one ports of legacy software. UIs designed for mouse clicks won’t work on a touch screen. I need not mention the poor track record of the usability of EMR software up to now. Do we really think that the same guys that gave us our existing crap software can produce compelling apps on an unfamiliar platform?

3) Interoperability is key. Vendors for everything from call-light systems to materials management equipment need to make it easy for new apps to interface with their solutions, either directly or through convenient middleware.

4) Last, and most important, how do we convince healthcare executives and shareholders that the costs of development and implementation are worth the benefits? As a bedside nurse, having a dreamy piece of slick iOS EMR software on an iPad with a barcode scanner would revolutionize the way I work, but how could that translate into terms that executives would appreciate? Will it reduce costs and improve quality? If so, and that is a big if, then the iPad has a chance. But it isn’t possible to reach that brave new world by rehashing the same ideas that brought us to the status quo. Healthcare needs more than an iPad. We need fresh talent and new ideas.

USA Today reports:

However, as realistic as they may seem, simulators are only as good as the data used to program them. Current simulators aren’t accurate when a plane goes out of control, which has prevented their use in training for the leading killer in commercial aviation.

The computing power necessary to simulate that kind of turbulence is more readily available than ever. There’s no excuse for training programs to not to develop more realistic simulators, especially if it could reduce accidents by half.

Health Affairs has published an article on EMR adoption rates across all U.S. hospitals. Their findings more or less reinforce what other similar studies found, in particular:

We found that public and rural hospitals had 40 percent lower odds of having adopted at least a basic electronic record in the year before the survey, compared to private nonprofit and urban hospitals, respectively.

I’m curious to know why smaller hospitals are slow to adopt EMRs. Is it simply a matter of cost? Or are their existing paper systems functioning well enough that they see no need to change?

This is a video of the TUG robot by Aetheon, used instead of a vacuum tube system to deliver medications and other items throughout a hospital. It’s cute.

MedPage Today reports that the FDA has recalled several brands of Huber access needles because of “coring,” which means they punch a thin sliver of silicone out of an otherwise self-healing access port when being inserted.

“Coring may lead to infection, damage or death of tissue, swelling, or other serious adverse health consequences, occurring as a result of the core traveling through blood vessels into the patient’s lungs. These issues may potentially cause death,” the FDA said in its recall notice.